CAJ | 학술논문

目的探讨损害控制技术在芦山地震严重多发伤伤员院内救治中的应用. 方法对2013年4月20日至5月2日应用损害控制技术救治的22例骨关节型地震严重多发伤伤员的临床资料进行回顾性分析,男13例,女9例；年龄20～60岁,平均43.1岁；创伤严重度评分为17 ～41分,平均25.8分；四肢开放性骨折11例,闭合性骨折10例. 结果共完成骨折手术38台,其中确定性手术24台,临时性手术13台,截肢术l台.9例伤员已完成全部确定性手术并在顺利康复之中,13例尚需进一步手术治疗.除l例患者外所有开放性伤口均已闭合.术后1例患者出现切口深部感染,予清创、负压封闭引流技术控制感染,13例行外固定治疗患者无一例发生外固定支架钉道松动、感染,复查术后X线片示骨折无成角畸形. 结论损害控制技术有利于提高地震所致严重多发伤伤员的救治成功率和减少死亡率,并为后期确定性治疗提供有利条件.
목적 탐토손해공제기술재호산지진엄중다발상상원원내구치중적응용. 방법 대2013년4월20일지5월2일응용손해공제기술구치적22례골관절형지진엄중다발상상원적림상자료진행회고성분석,남13례,녀9례；년령20～60세,평균43.1세；창상엄중도평분위17 ～41분,평균25.8분；사지개방성골절11례,폐합성골절10례. 결과 공완성골절수술38태,기중학정성수술24태,림시성수술13태,절지술l태.9례상원이완성전부학정성수술병재순리강복지중,13례상수진일보수술치료.제l례환자외소유개방성상구균이폐합.술후1례환자출현절구심부감염,여청창、부압봉폐인류기술공제감염,13례행외고정치료환자무일례발생외고정지가정도송동、감염,복사술후X선편시골절무성각기형. 결론 손해공제기술유리우제고지진소치엄중다발상상원적구치성공솔화감소사망솔,병위후기학정성치료제공유리조건.
Objective To report application of damage control orthopaedics in the hospital treatment of severe polytrauma patients after the earthquake at Yaan,Lushan,Sichuan,China.Methods A retrospective study was conducted to analyze the 22 severe polytrauma patients who had been treated from 20April to 2 May,2013 with damage control orthopaedics in our hospital.They were 13 men and 9 women,aged from 20 to 60 years (average,43.1 years).Their injury severity score (ISS) ranged from 17 to 41 points (average,25.8 points).There were 11 open limb fractures and l0 closed limb fractures.Results The patients received 38 operations,including 24 definite ones,13 temporary ones and one amputation.Nine patients were in the process of smooth rehabilitation after all the necessary definite operations,and 13 needed further operation.All the open injuries got closed at one stage except in one patient who had deep infection at the incision postoperation which had to be controlled by debridement and vacuum sealing drainage.No angulation deformity was observed by the postoperative radiographic evaluation,or no loosening or infection at the pin tracks of the external fixator was observed in all the 13 patients treated by external fixation.Conclusion Damage control orthopaedics can improve the cure rate of severe polytrauma patients in an earthquake rescue,decrease their mortality and facilitate later definite medical management.